Individual
YELENA SAMOFALOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 SOUTH ST STE 102, SOUTHBRIDGE, MA 01550-4051
(508) 765-7860
(508) 765-7861
Mailing address
PO BOX 40, SOUTHBRIDGE, MA 01550-0040
(508) 909-7799
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
223642
MA
Other
Enumeration date
08/18/2006
Last updated
01/04/2019
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